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NBME 23 Answers

nbme23/Block 1/Question#30 (26.8 difficulty score)
A 52-year-old man comes to the physician ...
Pelvic splanchnics🔍

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submitted by sajaqua1(462),
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hTe attnpei unterenwd lvremao of a tarecl tomru chwih had ioemtnnvelv ihtw eht oaesrtpt. heT potcrsiat euaplcs si hcir hwti eenvrs dlcgnuini het cievlp pinnsaclhc ers,nev a ste of caamttiperphsya seevnr boelrssepni ofr NPS aionucmto uigltrenoa. rsEeontic rae a hptpaesmiatyarc i.nuntcof

)A arGy mira mfor teh hityspamtec -hinac eriotnesc aer a sahpttpemaiyrca ctfnoiu,n tno eamits.hcpyt imEoisns of spemr is a itphcamytes ,noctnfiu adn is diedcetr by eht reniirof hcryopitgas veenr. C) nda-ePldu the ndaudpel reevn si a misocat vnere atht srceeeiv aionstesn fmro eth nis,ep ipotrroes ucsomtr, stiolric, nda aalib, as lwel sa bngie orblnesiesp orf mose emmntevo of hte elpcvi fro,ol adn luotnaacjie. D) priSuero ygschraopit eenr-v a ymiehtctpas ern,ev siht ocetisburtn ot eht tgcroiayhps slpxue adn yma asol itcobnetru to symthepcita cootnlr of si.esionm )E nelVrat ariem fo S-42-S hseTe iram oituctrbne ot hte lnpduaed vr.nee

focus  Diagrams here are pretty good too: "Point, Squeeze, Shoot" Point- erection: pelvic splanchnic nerves (S2-4) Squeeze- emission: superior hypogastric plexus Shoot- ejaculation: pudendal nerve +  

Just remember Point, Squeeze, and Shoot

Erection - Point Parasympathetic NS (pelvic splanchnics S2-S4)

Emission - Squeeze Sympathetic NS (hypogastric nerve T11-L2)

Ejaculation - Shoot visceral and Somatic nerves (Pudendal nerve)

FA19 pg. 609 (nice)

llamastep1  Emission, as the first phase of ejaculation, is a sympathetic spinal cord reflex and is defined as the deposition of seminal fluid into the posterior urethra. Ejaculation or expulsion is due to the combined action of sympathetic and somatic pathways. +  
mutteringly  actually on page 613 FA19 lol +